Abstract:
Objective: The repair of obstetric fistula is possible and potentially addresses the physical
ordeals, but the psycho-social afflictions with effect on patients’ self-efficacy may persist.
Meanwhile, inadequate evidence exists regarding the levels of self-efficacy among patients
in different repair categories, which incited this study.
Methods: Data was collected and analyzed among the 402 participants at St. Joseph Kitovu
Hospital Masaka, Uganda. 390 participants were involved in quantitative methods while
22 were involved in qualitative methods. Only obstetric fistula patients were involved in
the quantitative study, 10 of them in a qualitative study. The other 12 were key informants
who were included purposively. The patients were identified from the Urogynecology
department surgical logbook, randomly sampled using SPSS 25.0, invited by phone calls
and others identified through snowballing.
Results: Among the patients, 192 had had repair of the fistula, of which 82.3% had been
successful while 198 had not yet had fistula repair. The largest proportion (47.0%) was aged
19 to 29 years. The levels of self-efficacy among the patients included low, moderate and
high. The larger proportion (60.26%) had a moderate level, 20.00% had a high level while
19.74% had a low level of self-efficacy. However, when Pearson correlation was done,
the patients whose fistula had been repaired had a higher level of self-efficacy compared
to those with unrepaired fistula with all the attributes of self-efficacy having P-values of
<0.001 at a significant level of 0.05. Interviewees also reported that patients with repaired
fistula generally have higher levels of self-efficacy compared to those whose fistulas are
not yet repaired.
Conclusion: Obstetric fistula patients may have low, moderate or higher levels of self-
efficacy depending on the level of incontinence, repair status, and prior training in life
skills. Therefore, targeted strategies aimed to reduce incontinence and promote wellbeing
such as the repair of fistula, life skills training and counseling would improve the levels of
self-efficacy henceforth enhance social rehabilitation and reintegration.
